2D Measurements

Question 1

what is the normal TAPSE value ?

Answer 1

16 mm or greater

Question 2

what is the normal EF for men ?

Answer 2

52 - 72 %

Question 3

what is the normal EF for women ?

Answer 3

54 - 74%

Question 4

maximum LA volume for men/women ?

Answer 4

16- 34 ml

Question 5

what is normal RV pressure ?

Answer 5

systole: 15 - 25 mmHg
diastole: 2- 8 mmHg

Question 6

what is the normal LV pressure ?

Answer 6

systole: 120 mmHg
diastole: 3-12 mmHg

Question 7

what is the normal pressure for PA ?

Answer 7

systole: 15-25 mmHg
diastole: 4-12 mmHg

Question 8

wall motion terms:

what does hibernation mean ?

Answer 8

ischemic segment that is akinetic (no movement), but not infarcted, that can be reversed with restoration of coronary blood flow

Question 9

what does dyskinetic mean ?

Answer 9

movement away from the center of the cavity

Question 10

SV volume equation ?

Answer 10

SV = EDV - ESV

*normal range: 70-100 ml

Question 11

what is cardiac output (CO) ?

Answer 11

volume of blood that LV pumps each minute

Question 12

CO equation ?

Answer 12

CO = SV x HR

Question 13

what is the normal range of CO ?

Answer 13

4-8 L

Question 14

what is BSA ?

Answer 14

body surface area

Question 15

what is the normal BSA for adults ?

Answer 15

1.73 m2

Question 16

BSA equation ?

Answer 16

BSA = (height x weight / 3131) (1/2)

• unit: inches and lbs
• US machine automatically calculates BSA

Question 17

what is cardiac index (CI) ?

Answer 17

cardiac output correlated for the BSA

Question 18

CI equation ?

normal value ?

Answer 18

CI = CO/BSA

3-4 L/min2

Question 19

what is inotropic force ?

Answer 19

contractility of the heart muscle or the force of contraction

Question 20

chronotropic force

Answer 20

rate of contraction or heart rate

Question 21

afterload

Answer 21

the resistance that the heart must pump against

Question 22

preload

Answer 22

the volume in the heart at end[-diastole

Question 23

Amyl nitrite inhalation

Answer 23

less common maneuver that causes decreased peripheral resistance, which increases the heart rate, SV, and CO

Question 24

inspiration/squatting _____ venous return, SV, and CO; expiration/standing _____ venous return, SV, and CO

Answer 24

increase

decrease

Question 25

EF formula ? (Teicholts method)

Answer 25

EF% = LVIDV - LVISV/LVIDV x 100 *normal range for 20+ year old: 53-73%

Question 26

LVH severity scale: men normal value ? mild value ? severe value ?

Answer 26

6-10 mm 11-13 mm > and = 17 mm

Question 27

LVH severity scale: women normal value ? mild value ? severe value ?

Answer 27

6-9 mm 10-12 mm > and = 16 mm

Question 28

pulsus paradoxus

Answer 28

an exaggeration of the normal decrease in systolic blood pressure. to be considered abnormal, the drop must be greater than 10 mmHg . it is associated with cardiac tamponade

Question 29

thrills

Answer 29

palpable manifestations of loud, harsh murmurs with low frequency components. thrills are associated with AS and PS as well as VSD

Question 30

cachexia

Answer 30

a state of ill health, malnutrition and wasting and is associated with long standing heart disease

Question 31

Cor pulmonale

Answer 31

combination of hypertrophy and dilatation of RV caused by PH that results from a process intrinsic to the lung

Question 32

juglar venous distention

Answer 32

a term widely used to indicate high pressure in the right heart

Question 33

describe diastolic dysfunction

Answer 33

ventricles' ability to relax and fill

Question 34

3 things things that may impact 3DE by causing artifact

Answer 34

1. respiration 2. EKG gating 3. incorrect gain setting

Question 35

Frank-Sterling Law

Answer 35

the greater the amount of blood entering the chamber (greater preload), the greater the contraction (force) required to expel the blood

Question 36

what is Interval-Strength Relationship ?

Answer 36

the longer the interval between heartbeats, the stronger the contraction to eject the blood

Question 37

what is PAP ?

Answer 37

pulmonary artery perssure

Question 38

what are the 3 layers of the myocardium ?

Answer 38

epicardium myocardium endocardium

Question 39

Cartesian coordinate system

Answer 39

``` x = width y = height z = depth ```

Question 40

describe 3 factors that may impact cardiac afterload

Answer 40

1. AS/PS 2. systemic hypertension 3. PH

Question 41

strain phase _____ venous return, SV, CO and release phase ______ venous return, SV, CO

Answer 41

decrease | increase

Question 42

the degree of fiber stretch depends on the quantity of the blood in the chamber prior to contraction. T or F ?

Answer 42

T | *LVEDP: LV end diastolic pressure

Question 43

M-mod evaluation: normally when the MV opens on M-mod the anterior and posterior leaflets move _____ of each other (anterior leaflet ____ & posterior leaflet _____).

Answer 43

opposite upwards downwards

Question 44

when there is significant MS, the anterior and posterior leaflets move in the ______ direction ______.

Answer 44

same | upwards

Question 45

where is Thebesian valve located ?

Answer 45

between CS and RA

Question 46

what are thebasian veins ?

Answer 46

numerous, minute veins. return blood from the myocardium directly into cardiac chambers w/o entering the cardiac venous system

Question 47

adult TTE TDR have a frequency range of ______

Answer 47

2.0 - 3.5 MHz

Question 48

describe steps to improve image resolution for TTE (at least 4)

Answer 48

1. image minimum depth 2. utilize the highest possible TDR frequency 3. adjust gains, dynamic range 4. adjust frame rate 5. utilize harmonic imaging

Question 49

list wall segments that are seen in the PSAX view ( 6 segments)

Answer 49

1. anteroseptal wall 2. anterior wall 3. anterio-lateral wall 4. infero-lateral wall 5. inferior wall 6. infero-septal wall

Question 50

when demonstrating flow across the AoV in the A5, flow moving systematically will appear ____ the base line with CW and _______ with color Doppler

Answer 50

below | blue

Question 51

list at least 4 major technical areas that are controls on your u/s system that should be adjusted as you begin your echocardiogram

Answer 51

1. frequency 2. gain 3. harmonics 4. ECG signal

Question 52

your patient has a history of emphysema. what might you encounter as you perform their echocardiogram ?

Answer 52

patients with a history of emphysema often demonstrate hyperinflated lungs that may cause difficult parasternal window views. subcostal windows are typically the best window in patients with emphysema

Question 53

list items that are part of info inputted into the u/s system as you begin your echo (at least 4)

Answer 53

1. patient ID 2. patient full name 3. DOB 4. indication of exam 5. height & weight 6. BP

Question 54

advantage of M-mod assessment of LV size and function are:

Answer 54

high temporal resolution reproducible much published data

Question 55

list 4 limitation of M-mod

Answer 55

1. frequently off-axis beam alignment 2. one dimensional 3. assume fixed geometry 4. applies only to normal LV geometry 5. misleading if LV is remodeling i.e. dilated CM

Question 56

Doppler echo has two primary forms: _____ and ______

Answer 56

spectral and color flow

Question 57

________ is a technique used to process signals so that directionally or spatially selected signals can be sent or received from sensor arrays

Answer 57

beamforming

Question 58

ultrasound artifacts can occur when the basic assumption inherent in the system design regarding sound waves is not followed. which of the following is not inherent assumption?

Answer 58

sound travels in perpendicular lines

Question 59

advantage of M-mode ?

Answer 59

- much published data - reproducible - high temporal resolution

Question 60

aliasing occurs when the velocity is _____ while using pulsed Doppler

Answer 60

>2m/s